Wang Lars Peter, Paech Michael James
Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia.
Anesth Analg. 2008 Jul;107(1):193-200. doi: 10.1213/ane.0b013e31816c8888.
Neuroanesthesia for the pregnant patient is required infrequently, and evidence-based recommendations for neuroanesthetic management are sparse. We present a framework for a practical approach to anesthesia of the pregnant patient with subarachnoid or intracerebral hemorrhage, intracranial tumor, traumatic brain injury, spinal tumor, or spinal injury. The importance of a team-approach is emphasized. The anesthesiologist may have to anesthetize the pregnant patient for neurosurgery well before delivery, for cesarean delivery at the time of the neurosurgical procedure, or for delivery after neurosurgery. These scenarios are discussed along with fetal safety and anesthetic considerations for interventional neuroradiology.
对孕妇进行神经麻醉的情况并不常见，而且关于神经麻醉管理的循证建议也很少。我们提出了一个实用框架，用于处理患有蛛网膜下腔出血或脑出血、颅内肿瘤、创伤性脑损伤、脊髓肿瘤或脊髓损伤的孕妇的麻醉问题。强调了团队协作方法的重要性。麻醉医生可能需要在分娩前很久就为进行神经外科手术的孕妇实施麻醉，在神经外科手术时进行剖宫产，或者在神经外科手术后进行分娩。本文将对这些情况以及介入神经放射学的胎儿安全和麻醉注意事项进行讨论。
